颈项肩背痛古方与神经根型颈椎病今方常用药物的比较分析

目的:比较分析颈项肩背痛古方与神经根型颈椎病今方的用药特点。方法:检索以颈项肩臂痛、神经根型颈椎病为主治的古今内治方剂,比较古今方剂功效类别药物构成比和常用药物使用率的差异,分析它们的用药特点异同。结果:祛风湿药、活血化瘀药、补虚药在今方中使用构成比均大于20%,三者之和大于80%,在古方的使用构成比分别30.24%、17.70%、10.21%,化痰药、化湿利水药、温里药、行气药、清热药在古方中的使用构成比为5.86%～6.90%。祛风湿药今方常用葛根、桂枝、威灵仙、木瓜、桑枝,古方多用独活、麻黄、防风。补血药古今方均常用当归和白芍;益气药古方喜用白术,今方常用黄芪;古今方剂均较少使用补益肝肾药物。川芎是古今方剂最常用的活血化瘀药。化痰药以半夏、天南星较为常用,古方的使用率高于今方。全蝎等为今方所多用。古方喜用肉桂、附子等温里药。结论:今方的用药更趋集中于祛风湿药、补虚药、活血化瘀药等类别,而古方的选择上更为分散;古今方剂在常用药物的选择上各有特点。

Comparative Analysis of Common Drugs between Ancient Formulae for Pain Syndromes in Head Neck Shoulder and Arm and Modern Formulae for Cervicalspondylotic Radiculopathy

Objective : To compare and analyze the ancient and modern formulae for pain syndromes.Methods: Ancient and modern formulae for internal treatment of pain syndromes in head,neck and shoulder and cervicalspondylotic radiculopathy were searched and compared.Results: Wind-damp-expelling drugs,blood-activating and stasis-resolving drugs and deficiency-supplementing drugs accounted for more than 20% in modern formulae,the total was more than 80%.For the ancient formulae,the three kinds of drugs accounted for 30.24%,17.70%,10.21% respectively;phlegm-resolving drugs,dampness-eliminating and urine-promoting drugs,interior-warming drugs and heat-clearing drugs accounted for 5.86% ～ 6.90%.Gegen,Guizhi,Weilingxian,Mugua and Sangzhi are commonly used in modern formulae while Duhuo,Mahuang and Fangfeng commonly used in ancient formulae.For blood-nourishing durgs,Danggui and Baishao are both commonly used in ancient and modern formulae.For Qi-supplmenting drugs,Baizhu is commonly used in ancient formulae while Huagnqi in modern formulae.Both ancient and modern formulae have few kidney-liver supplementing drugs.Chuanxiong is the most common drug for blood-activating and stasis-resolving.Banxia and Tiannanxing are common for resolving phlegm.Quanxie is commonly used in modern formulae.In ancient formulae,Rougui and Fuzi which can warm the interior are commonly used.Conclusion : In modern formulae,wind-damp-expelling drugs,blood-activating and stasis-resolving drugs and deficiency-supplementing drugs are commonly used;but there is no clear drug laws for ancient formulae.Both the modern and ancient formulae have their own characteristics.